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1831301647
MIR WASIF ALI
SAN BERNARDINO, CA
NPI
1831301647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: CA A81819)
Enumeration Date
2007-05-04
Last Update Date
2017-09-21
Business Address
-- MIR WASIF ALI MD
401 E HIGHLAND AVE STE 251
SAN BERNARDINO, CA 92404-3800
Phone number: 909-882-4605
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Mailing Address
-- MIR WASIF ALI MD
3400 DATA DR ATTN: CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 95670-7956
Phone number:
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